Evidence map›Paper›PMID 31535270›Full record

Observational studyJournal of neurology2019

Retrospectively acquired cohort study to evaluate the long-term impact of two different treatment strategies on disability outcomes in patients with relapsing multiple sclerosis (RE.LO.DI.MS): data from the Italian MS Register.

Damiano Paolicelli, Giuseppe Lucisano, Alessia Manni, Carlo Avolio, Simona Bonavita, Vincenzo Brescia Morra, Marco Capobianco, Eleonora Cocco, Antonella Conte, Giovanna De Luca and 24 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors.

Damiano PaolicelliDepartment of Basic Medical Sciences, Neurosciences, and Sense Organs, Multiple Sclerosis Center, University of Bari "Aldo Moro", Bari, Italy. damiano.paolicelli@uniba.it.ORCID http://orcid.org/0000-0002-8645-1763
Giuseppe LucisanoCenter for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
Alessia ManniDepartment of Basic Medical Sciences, Neurosciences, and Sense Organs, Multiple Sclerosis Center, University of Bari "Aldo Moro", Bari, Italy.
Carlo AvolioDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Simona BonavitaDepartment of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.
Vincenzo Brescia MorraDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Naples, Italy.
Marco CapobiancoDepartment of Neurology and Regional Multiple Sclerosis Centre, University Hospital San Luigi, Orbassano, TO, Italy.
Eleonora CoccoDepartment of Medical Science and Public Health, University of Cagliari and Multiple Sclerosis Center, Cagliari, Italy.
Antonella ConteDepartment of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.
Giovanna De LucaNeurology Clinic, Multiple Sclerosis Centre, SS Annunziata Hospital, Chieti, Italy.
Francesca De RobertisDepartment of Neurology, Vito Fazzi Hospital, ASL, Lecce, Italy.
Claudio GasperiniDepartment of Neuroscience, San Camillo Hospital, Rome, Italy.
Maurizia GattoNeurology Unit, "F. Miulli" Hospital, Acquaviva delle Fonti BA, Italy.
Paola GazzolaDepartemental Center for the Diagnosis and Treatment of Demyelinating Diseases, Sestri Ponente, Genoa, Italy.
Giacomo LusDepartment of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.
Antonio IaffaldanoDepartment of Basic Medical Sciences, Neurosciences, and Sense Organs, Multiple Sclerosis Center, University of Bari "Aldo Moro", Bari, Italy.
Pietro IaffaldanoDepartment of Basic Medical Sciences, Neurosciences, and Sense Organs, Multiple Sclerosis Center, University of Bari "Aldo Moro", Bari, Italy.
Davide MaimoneMultiple Sclerosis Center, Garibaldi Hospital, Catania, Italy.
Giulia MallucciMultiple Sclerosis Center of IRCCS Mondino Foundation, Pavia, Italy.
Giorgia T ManiscalcoMultiple Sclerosis Regional Center, A. Cardarelli Hospital, Naples, Italy.
Girolama A MarfiaDepartment of Systems Medicine, Multiple Sclerosis Clinical and Research Center, University of Rome Tor Vergata, Rome, Italy.
Francesco PattiDepartment "G.F. Ingrassia", Multiple Sclerosis Center, University of Catania, Catania, Italy.
Ilaria PesciMultiple Sclerosis Center, Ospedale di Vaio (I.P.), Fidenza, PR, Italy.
Carlo PozzilliMultiple Sclerosis Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Marco RovarisMultiple Sclerosis Center, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Giuseppe SalemiDepartment of Biomedicine, Neuroscience and Advanced Diagnostics, Palermo University, Palermo, Italy.
Marco SalvettiDepartment of Neuroscience, Mental Health and Sensory Organs, Sapienza University, Rome, Italy.
Daniele SpitaleriUOC Neurology, AORN San G. Moscati, Avellino, Italy.
Rocco TotaroDepartment of Neurology, Demyelinating Disease Center, San Salvatore Hospital, L'Aquila, Italy.
Mauro ZaffaroniMultiple Sclerosis Center, Hospital of Gallarate, Gallarate, Italy.
Giancarlo ComiDepartment of Neurology, San Raffaele Hospital, Milan, Italy.
Maria Pia AmatoDepartment NEUROFARBA, University of Florence, Florence, Italy.
Maria TrojanoDepartment of Basic Medical Sciences, Neurosciences, and Sense Organs, Multiple Sclerosis Center, University of Bari "Aldo Moro", Bari, Italy.
Italian MS Register

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe increase in disease-modifying drugs (DMDs) allows individualization of treatment in relapsing multiple sclerosis (RMS); however, the long-term impact of different treatment sequences is not well established. This is particularly relevant for MS patients who may need to postpone more aggressive DMD strategies.

objectiveTo evaluate different therapeutic strategies and their long-term outcomes, measured as relapses and confirmed disability progression (CDP), in MS 'real-world' settings.

methodsMulticentre, observational, retrospectively acquired cohort study evaluating the long-term impact of different treatment strategies on disability outcomes in patients with RMS in the Italian MS Register.

resultsWe evaluated 1152 RMS-naïve patients after propensity-score adjustment. Patients included were receiving: interferon beta-1a (IFN-β1a) 44 µg switching to fingolimod (FTY; IFN-switchers; n = 97); FTY only (FTY-stayers; n = 157); IFN-β1a only (IFN-stayers; n = 849). CDP and relapses did not differ between FTY-stayers and IFN-switchers [HR (95% CI) 0.99 (0.48-2.04), p = 0.98 and 0.81 (0.42-1.58), p = 0.55, respectively]. However, IFN-stayers showed increased risk of relapses compared with FTY-stayers [HR (95% CI) 1.46 (1.00-2.12), p = 0.05].

conclusionThe ideal treatment option for MS is becoming increasingly complex, with the need to balance benefit and risks. Our results suggest that starting with FTY affects the long-term disease outcome similarly to escalating from IFN-β1a to FTY.

Indexed as

Disease ProgressionOutcome Assessment, Health CareRegistriesSeverity of Illness IndexAdultDrug Administration ScheduleFemaleFingolimod HydrochlorideHumansImmunologic FactorsInterferon beta-1aItalyMaleMiddle AgedMultiple Sclerosis, Relapsing-RemittingRetrospective StudiesFingolimod HydrochlorideImmunologic FactorsInterferon beta-1aEDSS scoreInterferonsLong-term outcomesMultiple sclerosisReal-world settingTreatment sequences

Identifiers

PMID31535270

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.